Epidemiology and Clinical Profile of Brachial Plexus Injuries in Semi-Urban Punjab: Insights From a Retrospective Study at a Tertiary Care Center

Background: Adult traumatic brachial plexus injury (BPI) is a severe peripheral nerve injury that frequently results in significant upper limb disability in young individuals. The epidemiology varies with different geographical locations. This study aimed to analyze the demographic profile, mechanisms of injury, injury severity patterns, referral timelines, and reconstructive burden of adult traumatic BPI in a tertiary care institution of northern India. Methods: A retrospective observational study was conducted at the All India Institute of Medical Sciences (AIIMS), Bathinda, Punjab, India, over a two-year period. Adult patients (≥18 years) with clinically and radiologically confirmed traumatic BPI were included. Cases of obstetric and iatrogenic brachial plexus injury were excluded. Data regarding age, sex, mechanism of injury, level and severity of plexus involvement, time to presentation, associated injuries, and management modality were collected. Descriptive statistical analysis was performed. Results: Seventy-five adult patients were included, with a mean age of 29.1 years; 69 (92%) were male. Road traffic accidents were the predominant cause, with two-wheeler accidents accounting for 78.7% of cases. Complete C5-T1 involvement was observed in 59 patients (78.7%). Forty-five patients (60%) presented more than six months after injury. At the time of analysis, 51 patients (68%) had undergone surgical intervention, including primary nerve transfer and secondary reconstructive procedures, while 24 (32%) had not undergone operative treatment. Conclusion: Adult traumatic BPI in this semi-urban North Indian cohort was predominantly associated with high-energy two-wheeler accidents and a high proportion of complete plexus injuries, with frequent delayed presentation. These findings highlight the substantial reconstructive demand in tertiary centers and underscore the need for improved referral pathways and trauma prevention strategies.